This invention relates to compounds and methods for inducing or promoting apoptosis and for arresting uncontrolled neoplastic cell proliferation, methods that are specifically useful in the arresting and treatment of neoplasias, including precancerous and cancerous lesions.
Pharmaceuticals that are effective against early stage neoplasias comprise an emerging and expanding area of research and potential commercial development. Such pharmaceuticals can delay or arrest development of precancerous lesions into cancers. Each year in the United States alone, untold numbers of people develop precancerous lesions, which exhibit a strong statistically significant tendency to develop into malignant tumors, or cancer. Such lesions include lesions of the breast (that can develop into breast cancer), lesions of the skin (that can develop into malignant melanoma or basal cell carcinoma), colonic adenomatous polyps (that can develop into colon cancer), cervical displasia (cervical cancer) and other such neoplasms.
Such compounds and methods are particularly beneficial to sub-populations of patients who repeatedly develop precancerous lesions, and therefore have a statistically higher probability of getting cancer. Many cancer types (e.g., breast, colon, prostate etc.) have such patient sub-populations.
The search for drugs useful for treating and preventing neoplasias in their earliest stages is intensive because chemotherapy and surgery on cancer itself is often not effective, and current cancer chemotherapy has severe side effects. Such cancer-preventative compounds are also envisaged for recovered cancer patients who retain a risk of cancer reoccurrence, and even for cancer patients who would benefit from compounds that selectively induce apoptosis in neoplastic, but substantially not in normal cells.
Because it is believed that chronic administration of cancer-preventative pharmaceuticals is necessary to inhibit or arrest the development of neoplasia, standard cancer chemotherapeutic drugs are not considered appropriate drugs for cancer chemoprevention because whatever cancer preventative (as opposed to cancer-fighting) capabilities those drugs may possess do not outweigh their severe side effects. Most standard chemotherapeutics are now believed to kill cancer cells by inducing apoptosis (also sometimes referred to as xe2x80x9cprogrammed cell deathxe2x80x9d). Apoptosis naturally occurs in many tissues in the body. Apoptosis plays a critical role in tissue homeostasis, that is, it ensures that the number of new cells produced are correspondingly offset by an equal number of cells that die. Apoptosis is especially pronounced in self-renewing tissues such as bone marrow, immune cells, gut, and skin. For example, the cells in the intestinal lining divide so rapidly that the body must eliminate cells after only three days to protect and prevent the overgrowth of the intestinal lining.
Standard chemotherapeutics promote apoptosis not only in cancer cells, but also in normal human tissues, and therefore have a particularly severe effect on tissues where apoptosis is especially pronounced (e.g. hair, gut and skin). The results of those effects include hair loss, weight loss, vomiting and bone marrow immune suppression. Thus, standard chemotherapeutics are inappropriate for cancer prevention, particularly if chronic administration is indicated.
Several non-steroidal anti-inflammatory drugs (xe2x80x9cNSAIDsxe2x80x9d), originally developed to treat arthritis, have shown effectiveness in inhibiting and eliminating colonic polyps. Polyps virtually disappear when the patients take the drug, particularly when the NSAID sulindac is administered. However, the continued prophylactic use of currently available NSAIDs, even in high colon cancer-risk patients, is still marked by severe side reactions that include gastrointestinal irritations, perforations, ulcerations and kidney toxicity believed to be produced by inhibition of prostaglandin synthetase activity (xe2x80x9cPGE-2xe2x80x9d). Such inhibition is a requirement for the NSAIDs anti-inflammatory action since elevated levels of PGE-2 are associated with inflammation. PGE-2 plays a protective function in the gastrointestinal tract, which is the reason such gastric side effects arise with chronic NSAID therapy, which is rarely indicated for arthritis sufferers, acute therapy being the norm for them. However, chronic administration of sulindac is important for high cancer-risk patients to eliminate and prevent future polyps which causes gastric side effects in many such patients. Once NSAID treatment is terminated due to such complications, the neoplasms return, particularly in high risk patients.
Compounds such as those disclosed in U.S. Pat. No. 5,643,959 have exhibited advantages in the treatment of neoplastic lesions since such compounds have been shown to induce apoptosis in neoplastic cells but not in normal cells in humans. Thus, the severe side effects due to induction of apoptosis in normal cells by conventional chemotherapeutics are avoided by these novel therapeutics (see, Van Stolk, et al., Gastroenterology. 112 (4): A673, 1997). In addition, such compounds do not exhibit the gastric side effects associated with NSAIDs since such compounds do not substantially inhibit PGE-2. More potent compounds with such neoplasia specificity but without substantial PGE-2 activity are desirable.
This invention represents potent compounds that induce apoptosis in neoplastic cells (but not substantially in normal cells), for treating patients with neoplastic lesions without substantially inhibiting PGE-2. This invention also involves methods for inducing such specific apoptosis in neoplastic cells by exposing such cells to a pharmacologically effective amount of those compounds described below to a patient in need of such treatment. Such compositions are effective in modulating apoptosis and modulating the growth of neoplasms, but are not suffering from the side effects of conventional chemotherapeutics and NSADDs.
As discussed above, the present invention utilizes compounds of Formula I below 
wherein R1 is substituted or unsubstituted aryl, and wherein said aryl group is selected from the group consisting of phenyl, benzyl, pyridyl, dibenzofuranyl, naphthyl, quinolinyl and isoquinolinyl and wherein said substituents are one to three selected from the group consisting of halogen, lower alkyl, lower alkoxy, aryloxy, lower haloalkyl, CN, amino, nitro, phenyl;
R2 is selected from a group consisting of hydrogen, halo-substituted or unsustituted lower alkyl, and lower alkoxy;
R3 and R4 are independently selected from a group consisting of hydrogen, lower alkyl, xe2x80x94C(O)xe2x80x94R5, xe2x80x94CH2xe2x80x94R5, or xe2x80x94SO2xe2x80x94R5;
R5 is selected from a group consisting of halo-substituted or unsubstituted lower alkyl, lower alkoxy, NHR6, lower alkenyl, and substituted or unsubstituted aryl, wherein said aryl group is selected from the group consisting of phenyl, benzyl, pyridyl, or pyridylmethyl, quinolinyl, thiazolyl, tetrazolyl, thiadiazolyl, and triazolyl and wherein said substituents are one to three independently selected from a group consisting of hydrogen, lower alkyl and lower alkoxy;
R6 is hydrogen or lower alkyl;
R7 is selected from a group consisting of halogen, lower alkoxy, lower alkyl, lower alkoxycarbonyl, carboxyl, and carbamoyl; and
x and y are 0, 1, or 2.
The present invention is also a method of treating individuals with neoplastic lesions by administering a pharmacologically effective amount of an enterically coated pharmaceutical composition that includes compounds of this invention.
Preferably, such compounds are administered without therapeutic amounts of an NSAID.
Also, the present invention is a method of inhibiting the growth of neoplastic cells by exposing the cells to an effective amount of compounds of Formula I, wherein R1, R2, R3, R4, R5, R6, Ra7, m, n, x, and y are defined as above.
In still another form, the invention is a method of inducing apoptosis in human cells by exposing those cells to an effective amount of compounds of Formula I, wherein R1 through R7 m, n, x and y are defined as above where such cells are sensitive to these compounds.
Additionally, in yet another form, the invention is a method of treating a patient having a disease which would benefit from regulation of apoptosis by treating the patient with an effective amount of compounds of Formula I, wherein R1 through R7 etc. are defined as above. The regulation of apoptosis is believed to play an important role in diseases associated with abnormalities of cellular growth patterns such as benign prostatic hyperplasia, neurodegenerative diseases such as Parkinson""s disease, autoimmune diseases including multiple sclerosis and rheumatoid arthritis, infectious diseases such as AIDS, and other diseases, as well.
As used herein, the term xe2x80x9cprecancerous lesionxe2x80x9d includes syndromes represented by abnormal neoplastic, including dysplastic, changes of tissue. Examples include dysplasic growths in colonic, breast, bladder or lung tissues, or conditions such as dysplastic nevus syndrome, a precursor to malignant melanoma of the skin. Examples also include, in addition to dysplastic nevus syndromes, polyposis syndromes, colonic polyps, precancerous lesions of the cervix (i.e., cervical dysplasia), esophagus, prostatic dysplasia, bronchial dysplasia, breast, bladder and/or skin and related conditions (e.g., actinic keratosis), whether the lesions are clinically identifiable or not.
As used herein, the term xe2x80x9ccancerousxe2x80x9d refers to lesions that are malignant. Examples include malignant melanomas, breast cancer, prostate cancer and colon cancer.
As used herein, the term xe2x80x9cneoplasmxe2x80x9d refers to both precancerous and cancerous lesions and hyperplasia.
As used herein, the term xe2x80x9chaloxe2x80x9d or xe2x80x9chalogenxe2x80x9d refers to chloro, bromo, fluoro and iodo groups, and the term xe2x80x9calkylxe2x80x9d refers to straight, branched or cyclic alkyl groups and to substituted aryl alkyl groups. The term xe2x80x9clower alkylxe2x80x9d refers to C1 to C8 alkyl groups.
The term xe2x80x9clower alkoxyxe2x80x9d refers to alkoxy groups having from 1 to 8 carbons, including straight, branched or cyclic arrangements.
The term xe2x80x9cpharmaceutically acceptable saltxe2x80x9d refers to non-toxic acid addition salts and alkaline earth metal salts of the compounds of Formula I. The salts can be prepared in situ during the final isolation and purification of such compounds, or separately by reacting the free base or acid functions with a suitable organic acid or base, for example. Representative acid addition salts include the hydrochloride, hydrobromide, sulfate, bisulfate, acetate, valerate, oleate, palmatate, stearate, laurate, borate, benzoate, lactate, phosphate, tosylate, mesylate, citrate, maleate, fumarate, succinate, tartrate, glucoheptonate, lactobionate, lauryl sulfate salts and the like. Representative alkali and alkaline earth metal salts include the sodium, calcium, potassium and magnesium salts.
Compounds of this invention may be formulated into pharmaceutical compositions together with pharmaceutically acceptable carriers for oral administration in solid or liquid form, or for rectal or topical administration, although carriers for oral administration are most preferred.
Pharmaceutically acceptable carriers for oral administration include capsules, tablets, pills, powders, troches and granules. In such solid dosage forms, the carrier can comprise at least one inert diluent such as sucrose, lactose or starch. Such carriers can also comprise, as is normal practice, additional substances other than diluents, e.g., lubricating agents such as magnesium stearate. In the case of capsules, tablets, troches and pills, the carriers may also comprise buffering agents. Carriers such as tablets, pills and granules can be prepared with enteric coatings on the surfaces of the tablets, pills or granules. Alternatively, the enterically coated compound can be pressed into a tablet, pill, or granule, and the tablet, pill or granules for administration to the patient. Preferred enteric coatings include those that dissolve or disintegrate at colonic pH such as shellac or Eudraget S.
Pharmaceutically acceptable carriers include liquid dosage forms for oral administration, e.g., pharmaceutically acceptable emulsions, solutions, suspensions, syrups and elixirs containing inert diluents commonly used in the art, such as water. Besides such inert diluents, compositions can also include adjuvants such as wetting agents, emulsifying and suspending agents, and sweetening, flavoring and perfuming agents.
Pharmaceutically acceptable carriers for topical administration include DMSO, alcohol or propylene glycol and the like that can be employed with patches or other liquid-retaining material to hold the medicament in place on the skin so that the medicament will not dry out.
Pharmaceutically acceptable carriers for rectal administration are preferably suppositories that may contain, in addition to the compounds of this invention excipients such as cocoa butter or a suppository wax, or gel.
The pharmaceutically acceptable carrier and compounds of this invention are formulated into unit dosage forms for administration to a patient. The dosage levels of active ingredient (i.e., compounds of this invention) in the unit dosage may be varied so as to obtain an amount of active ingredient effective to achieve lesion-eliminating activity in accordance with the desired method of administration (i.e., oral or rectal). The selected dosage level therefore depends upon the nature of the active compound administered, the route of administration, the desired duration of treatment, and other factors. If desired, the unit dosage may be such that the daily requirement for active compound is in one dose, or divided among multiple doses for administration, e.g., two to four times per day.
The pharmaceutical compositions of this invention are preferably packaged in a container (e.g., a box or bottle, or both) with suitable printed material (e.g., a package insert) containing indications, directions for use, etc.
There are several general schemes for producing compounds useful in this invention. 
A substituted amide (a) is allowed to react with a base such as sodium hydride, lithium diisopropylamide. Reaction with a compound expressed by R2Z (Z represents a halogen atom or a sulfonyl chloride) gives the tertiary amide (b). There are several methods to obtain a compound of the formula (c). (A) Reduction with iron or zinc under an acidic condition, (B) reduction with a transition metal catalyst primarily exemplified by palladium, platinum, ruthenium, and nickel under a hydrogen environment, (C) reduction with a transition metal catalyst primarily exemplified by palladium, platinum, ruthenium, and nickel under a presence of formic acid, or (D) reduction with sodium hydrosulfite. In many cases when method (A) is used, a compound of the formula (c) is reduced within the reaction system to directly produce a compound of the formula (d). Some compounds may partially produce a compound of the formula (d) under any condition in the methods (A) through (D). A compound of the formula (d) is produced from a compound of the formula (c) with a carboxylic acid such as acetic acid, p-toluenesulfonic acid, hydrochloric acid, sulfuric acid, or phosphoric acid, sulfonic acid, or an inorganic acid. 
In scheme II, a compound of the formula (e) undergoes a hydrolysis or solvolysis with a base such as lithium bicarbonate, lithium carbonate, lithium hydroxide, sodium bicarbonate, sodium carbonate, sodium hydroxide, potassium bicarbonate, potassium carbonate, or potassium hydroxide, a carboxylic acid such as acetic acid, p-toluenesulfonic acid, hydrochloric acid, sulfuric acid, or phosphoric acid, sulfonic acid, or an inorganic acid and produces a compound expressed by the formula (f). A compound of the formula (f) is processed with a base such as sodium hydride, lithium diisopropylamide, and is processed with a compound expressed by R1bZ (Z represents a halogen or sulfonyl chloride) in order to produce a compound of the formula (g). A compound of the formula (g) can be altered to a compound of the formula (h) by a method such as (A) reducing it with iron or zinc under an acidic condition, (B) reducing it with a transition metal catalyst primarily exemplified by palladium, platinum, ruthenium, and nickel under a hydrogen environment, (C) reducing it with a transition metal catalyst primarily exemplified by palladium, platinum, ruthenium, and nickel under a presence of formic acid, and (D) reducing it with sodium hydrosulfite. A compound of the formula (i) is produced from a compound of the formula (h) and a corresponding carboxylic acid, acid chloride, acid bromide, or acid anhydride. 
In scheme III, a compound of the formula (k) is produced from a compound of the formula (j) and a compound expressed by R1NH2. The alteration of a compound of the formula (k) to a compound of the formula (m) is the same as that of a compound of the formula (g) to a compound of the formula (i) in scheme II. 
In scheme IV, a compound of the formula (n) can be altered to a compound of the formula (o) by a method such as (A) reducing it with a transition metal catalyst primarily exemplified by palladium, platinum, ruthenium, and nickel under a hydrogen environment, and (B) reducing it with sodium hydrosulfite. A compound of the formula (o) is processed with a base such as lithium hydrogencarbonate, lithium carbonate, lithium hydroxide, sodium hydrogencarbonate, sodium carbonate, sodium hydroxide, potassium hydrogencarbonate, potassium carbonate, or potassium hydroxide, and with a compound expressed by R1Z (Z represents a halogen atom, , or a sulfonyl chloride.) in order to produce a compound of the formula (p). A compound of the formula (q) is produced from a compound of the formula (p) with a carboxylic acid such as acetic acid, p-toluenesulfonic acid, hydrochloric acid, sulfuric acid, or phosphoric acid, sulfonic acid, or an inorganic acid. 
In scheme V, a compound of the formula (r) can be altered to a compound of the formula (s) by a method such as (A) reducing it with reduced iron or zinc under an acidic condition, (B) reducing it with a transition metal catalyst primarily exemplified by palladium, platinum, ruthenium, and nickel under a hydrogen environment, (C) reducing it with a transition metal catalyst primarily exemplified by palladium, platinum, ruthenium, and nickel under a presence of formic acid, and (D) reducing it with sodium hydrosulfite. A compound of the formula (t) is produced from a compound of the formula (s) and a corresponding carboxylic acid, acid anhydride, acid chloride, or acid bromide. A compound of the formula (t) is processed with a base such as sodium hydride or lithium diisopropylamide, and is processed with a compound expressed by R1Z (Z represents a halogen atom, or a sulfonyl chloride.) in order to produce a compound of the formula (u).
These methods usually produce a compound of the formula (u) having R3 at mixed substitution positions of the fifth and sixth or of the fourth and seventh. The materials can be purified by a means such as recrystallization, column chromatography, thin film chromatography, or high speed liquid chromatography. 
In scheme VI, a compound of the formula (v) can be altered to a compound of the formula (w) by a method such as (A) reducing it with reduced iron or zinc under an acidic condition, (B) reducing it with a transition metal catalyst primarily exemplified by palladium, platinum, ruthenium, and nickel under a hydrogen environment, (C) reducing it with a transition metal catalyst primarily exemplified by palladium, platinum, ruthenium, and nickel under a presence of formic acid, and (D) reducing it with sodium hydrosulfite. In many cases when the method (A) is used, a compound of the formula (w) forms a ring within the reaction system to directly produce a compound of the formula (x). Some compounds may partially produce a compound of the formula (x) under any condition in the methods (A) through (D). A compound of the formula (x) is produced from a compound of the formula (w) with a carboxylic acid such as acetic acid, p-toluenesulfonic acid, hydrochloric acid, sulfuric acid, or phosphoric acid, sulfonic acid, or an inorganic acid. A compound of the formula (x) can be altered to a benzimidazole compound by using the alteration method from the formula (t) to the formula (u) in scheme V. These methods usually produce a compound of the formula (y) having R3 at mixed substitution positions of the fifth and sixth or of the fourth and seventh. The materials can be purified by a means such as recrystallization, column chromatography, thin film chromatography, or high speed liquid chromatography. 
In scheme VII, a compound of the formula (A) undergoes a hydrolysis with a base such as lithium hydroxide, sodium hydroxide, and produces a compound of the formula (B). A compound of the formula (B) is processed with carbonyldiimidazole and then is processed with an amine or a sulfonamnide under a presence of a base to further produce benzimidazole derivatives.
A compound of the formula (B) can be altered to an acid halide expressed by the formula (C) by thionyl chloride, thionyl bromide, phosphorus trichloride, phosphorus pentachloride, or phosphorus oxychloride. Benzimidazole derivatives can be further produced by reacting a compound of the formula (C) with an amine or a sulfonamide. 
In scheme VIII, a compound of the formula (B) can be processed with an azide, primarily exemplified by diphenylphosporylazide, under a presence of an alcohol, primarily exemplified by t-butanol, to produce a compound of the formula (D). When a compound of the formula (D) is decomposed with an acid, a compound of the formula (E) is produced. A compound of the formula (F) is produced from a compound of the formula (E) and a compound expressed by R3Z, wherein Z represents a halogen atom. 
In schemeIX, a compound of the formula (A) can be altered by reduction to a compound of the formula (G). Furthermore, a compound of the formula (G) can be altered to a compound of the formula (H) by thionyl chloride, thionyl bromide, phosphorus oxychloride, phosphorus oxybromide, phosphorus trichloride, phosphorus pentachloride, methanesulfonyl chloride, or toluenesulfonyl chloride.